ong120
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A thai man.He is 49 years old,live in Thailand.
Chife complain ; Weakness and numbness at lower extremities 3 wk ago
Present illness ; 3 wk ago He has progressive distal muscle weakness and numbness(Like Glove and stocking pattern) in his lower extremities.He has anorexia and weight loss 3 kg in a month.
His skin generalized increase in pigment and has multiple cervical lymphnode in chain not tender for 5 years.
He has no fever,no cough,no chest pain,sometime has tightness in epigastrium not relate meal.
Past history : DM 6 months ago on glibenclamide 1x1,good control,no symptom of hypoglycemia
No Drinking,No smoking ,no steriod or NSAID used,no drug allergy
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| ong120
Forum Newbie
Topics: 1
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PE :
V/S T 37C RR 16/min PR 80/min BP 130/80 mmHg
GA A Thai middle age man,normal body built,good consciousness,not pale,no jaundice,no edema.
Skin Diffuse pigmented skin.Hypertrichosis at both forearm and pretibial area
HEENT oral cavity- no ulcer,no dental caries,tonsil not enlarge,
thyroid gland- not enlarge.
bilateral anterior cervial lymphadenipathy diameter 1-2 cm. line in chains
Heart/Lung WNL
Abdomen Soft,not tender,
liver - enlarge 2 FB below RCM,span 14 cm,soft,not tender
Spleen-enlarge 2 FB below RCM.not tender,
Bimanual palpation - not palpable
No shifting dullness,normoactive bowel sound
Nuurological CN - Intact all
Motor - normal tone,muscle power upper limb gr V,Lower limb gr IV
Sensation - decrease pain sensation from just below knee sides to toe
DTR - Upper limb gr I+
Lower limb gr II+
BKK-Negative
LAB :
CBC HCT 45% WBC 12000 (PMN 80%,L 20%) Plt 450,000
UA wnl
Blood chemistry
random blood suger160 mg/dl HbA1c 7.2
BUN/Cr 24/1.2
Na 138 ,K 36,HCO3 23,Cl 108
LFT Chol 226,TP 7.2,alb 3.1,Glob 4.1,TB 0.6,DB 0.2,SGOT 18,SGPT 38,ALP 112
AntiHIV Neg
CXR WNL
U/S abdomen Hepatosplenomegaly without mass lesion.
Kidney ,pancrease -unrenarkable
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